Surgical cell, biologics and drug deposition in vivo, and real-time tissue modification with tomographic image guidance and methods of use

Abstract

Provided herein are systems, methods and apparatuses for an in vivo surgical device that uses tomographic imaging to guide the process of surgical incisions for cell, biologics and drug delivery; the image guided system guides the process of delivery with comprehensive real-time processing with the ability to seal the location of delivery and offer laser-tissue modification via a co-aligned tissue modification beam on tissue without tissue damage to adjacent critical or delicate structures.

What is claimed is: 
     
         1 . An image guided system comprising:
 an Optical Coherence Tomography (OCT) imaging system to provide high resolution, three-dimensional image information;   providing an OCT image of a diseased area and a non-diseased area surrounding the tissue; and   a surgical tool for a treatment of the diseased area.   
     
     
         2 . The system of  claim 1 , wherein the surgical tool is a laser system including a pulse energy, a laser pulse duration, a pulse repetition rate, a spot size, and a laser emission wavelength; and the laser minimizes non-specific damage to non-diseased area surrounding the tissue through the OCT imaging system. 
     
     
         3 . The image guided system of  claim 2 , wherein the OCT image is computed using OCT processing techniques include acquiring the spectral fringe signal to two-byte values, applying a Hanning window, computing a fast Fourier transform and a resultant power spectrum vs. time delay of light propagating into the diseased area and the non-diseased area surrounding the tissue. 
     
     
         4 . The image guided system of  claim 3 , wherein the OCT imaging system controls the lateral positions of the laser system by a motor control and controls an average power level, wherein the laser system includes a plurality of profiles of a laser turn-ON time and a laser turn-OFF time that avoided non-diseased area surrounding the tissue and stored in a computer-readable media based on the OCT images including an A-scan location. 
     
     
         5 . The image guided system of  claim 4 , wherein the image guided system approves a proposed ablation pattern to initiate tissue removal by reading the computer-readable media and turning on the laser system at the appropriate A-scan locations during imaging of a next OCT image frame so as to avoid non-diseased area surrounding the tissue through 2D image processing 
     
     
         6 . The image guided system of  claim 4 , wherein the 2D image processing includes an Edge/Flow detection and an ablation profile generation. 
     
     
         7 . An image guided system comprising
 a Combined Holistic Surgical View subsystem operably coupled to a Feature Detection Image Overlay subsystem, an examination system operably coupled to the Feature Detection Image Overlay subsystem, a Positioning subsystem operably coupled with an examination system, and a Treatment system operably coupled with the Positioning subsystem;   the Combined Holistic Surgical View subsystem includes an imaging system for preoperative imaging and intraoperative imaging, where the imaging system combines the preoperative imaging and intraoperative imaging into one holistic view of a surgical field, and the imaging system provides a high resolution volume OCT image;   the Feature Detection Image Overlay subsystem analyzes the OCT volume image, highlights features of surgical relevance, and overlays the OCT volume image on the holistic view;   the examination system conducts an examination to determine where to position a surgical instrument, and the examination system performs the examination and acquires secondary OCT volume images by the examination system interacting with the feature detection overlay system to highlight structural features;   the Positioning subsystem includes the examination system coupled with the combined holistic view and a highlight of structural features, and the Positioning subsystem positions the surgical instrument within an x,y,z location of the surgical field that is constantly tracked by the imaging system to detail the surgical instrument's position within the surgical field and integrates new OCT image data into the combined holistic surgical view; and   the treatment system executes a treatment on the tissue and is operably coupled with the imaging system to acquire OCT images simultaneously with the treatment.   
     
     
         8 . The image guided system of  claim 7 , wherein the treatment is a laser treatment and treatment system controls laser dosimetry and laser energy. 
     
     
         9 . The image guided system of  claim 8 , wherein the treatment system is a robotic treatment system. 
     
     
         10 . The image guided system of  claim 8 , wherein the treatment includes a myocardial infarct, the Feature Detection Image Overlay subsystem detects blood vessels, ischemic tissue, and the sites for microwell incision; the treatment system drives the laser to laser-cut microwells into the epicardium while avoiding unwanted damage to the vascular sites and, the treatment system includes an injector to deposit angiogenic chemokines to penetrate the myocardial infarct at the microwells; and the vascular sites is sealed with the tomographic image guidance controlling the co-aligned tissue modifying laser. 
     
     
         11 . The image guided system of  claim 8 , wherein the treatment is cancer, the treatment system provides highly localized chemotherapeutic or radiological-seed treatment to cancer margins as tumor tissue is imaged and classified in vivo, the image-guided system includes tomographic image guidance to use a laser to cut tissue and inject these chemotherapeutic or radiological-seed treatment, and seal the tissue with laser modification of the surface of the tissue. 
     
     
         12 . The image guided system of  claim 8 , wherein the treatment is damaged articular cartilage, where tomographic imaging reveals damaged cartilage tissue, the image guided system then deposits autologous stem cells into microwells; the treatment system includes multiplexing cell laden hydro-gel with normal hydro-gel to ensure no cross-contamination and a secondary conduit in the image guided system transfers the solvent location in order to seal the cartilage. 
     
     
         13 . An image guided system comprising an OCT imaging system operably coupled with a laser system, wherein the OCT Imaging system includes an OCT source and the OCT source is a swept-source mode-locked laser source, a sample arm and a reference arm, where backscattered light from the reference arm and sample arm interfere to form a fringe. 
     
     
         14 . The image guide system of  claim 13 , wherein the swept-source mode-locked laser source is centered at about 1310 nm±70 nm, with a fast scan-rate of about 100 kHz; and the sample arm and the reference arm are path length and dispersion matched. 
     
     
         15 . The image guided system of  claim 14 , wherein the laser system is a nanosecond pulsed fiber laser system used for cutting the tissue and the laser system co-aligns a cutting laser beam with an OCT beam to produce a combined laser/OCT beam. 
     
     
         16 . The image guided system of  claim 15 , further comprising a Biomaterial/Cell deposition system operably coupled with the laser system to deposits a material onto a modified tissue. 
     
     
         17 . The image guided system of  claim 16 , wherein the Biomaterial/Cell deposition system is loaded with a cell-seeded-polymer and a cross-linking agent to form a hydrogel deposition. 
     
     
         18 . The image guided system of  claim 17 , wherein the OCT system positions Biomaterial/Cell deposition system to a micro-well in the tissue and the OCT system adjusts location of subsequent images to capture the hydrogel deposition. 
     
     
         19 . The image guided system of  claim 18 , wherein the Biomaterial/Cell deposition system includes an applicator-optical mount that interfaces directly with an optical table mount and the Biomaterial/Cell deposition system where the hydrogel deposition can be imaged without adjustment. 
     
     
         20 . The image guided system of  claim 8 , wherein the laser coagulates the tissue and then the laser removes the tissue.